Endoscopic removal of dysfunctioning bands or rings after restrictive bariatric procedures
Received 23 February 2009; accepted 17 June 2009. published online 14 September 2009.
Background
Intragastric band migrations or dysfunctions are common long-term complications of both vertical banded gastroplasty (VBG) and laparoscopic adjustable gastric banding (Lap-Band) that classically require surgical treatment.
Objective
In this series, we describe the endoscopic removal of partially eroded Lap-Bands or Silastic rings and noneroded dysfunctioning rings after VBG.
Design
Case series.
Setting
A European, tertiary-care academic center.
Patients
This study involved 13 patients—3 with eroded Lap-Bands, 4 with eroded Silastic rings, and 6 with refractory outlet stoma stenosis after VBG.
Intervention
Endoscopic removal was performed within 1 or 2 sessions, according to the presence and extent of band erosion at presentation, including optional placement of a self-expandable plastic stent across the band, followed about 6 to 8 weeks later by extraction with transsection, if needed, by using a wire-cutting system.
Main Outcome Measurements
Technical success and safety.
Results
One failure was caused by huge adhesion formation around a Lap-Band on the lesser curvature of the stomach and the left liver lobe. Twelve of 13 endoscopic removals were successful in 1 (n = 2) and 2 (n = 10) sessions.
Current affiliations: Department of Gastroenterology and Hepato-pancreatology, Hôpital Erasme, Université Libre de Bruxelles, Belgium
Reprint requests: Daniel Blero, MD, Department of Gastroenterology, Hôpital Erasme, 808 route de Lennik, 1070 Bruxelles, Belgium.
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. Daniel Blero was supported by a grant from Fonds Erasme pour la recherche Médicale and a Cook Endoscopy grant for research in GI endoscopy.
ABSTRACT